After Health Care Flop, GOP Should Repeal IPAB

Without a doubt, the last few weeks have been disappointing for conservatives who have fought for years to repeal Obamacare. There is a real need to replace this dysfunctional nightmare with a market-based alternative — one that gives the American people more health care choices and lowers consumer costs through fostering market competition.

While congressional Republicans continue back-channel negotiations and the White House attempts to strong arm a “vote” before 100 days, it is unlikely any legislation will pass the House of Representatives this week. No one can know how close House Republicans are to consensus — or how far apart Senate Republicans remain.

It is time for Congress to use other strategies to build momentum and help Republicans pass a replacement for Obamacare. Searching for one silver bullet has not succeeded and is only allowing opponents of reform to further confuse the public with scare tactics, building hardened public opinion against any solution they put forward.

To build popular support, there are a number of provisions within Obamacare that the public is nearly universally united in support of repeal. Eliminating some of the self-serving programs senators inserted in Obamacare, like the “Kerry Kickback” or the “Cornhusker Kickback,” would be easy votes that most Democrats would be forced to support.

But perhaps the foremost provision of Obamacare the public wants cut is the Independent Payment Advisory Board (IPAB). This was the mechanism Democrats created to conceal health care rationing from public accountability. Republicans could pass a bill to repeal IPAB tomorrow, removing one of the worst parts of the law and building political momentum behind the larger repeal effort.

For multiple reasons, IPAB, often dubbed Obamacare’s “death panel,” is a uniquely terrible part of the law.

First, the purpose of IPAB is to ration health care. Conservatives have long fought against rationing health care, which is an inevitable consequence of using the government to distribute resources. This is a crucial argument. The media will continue to repeat the false argument that Republicans are trying to take health care away from people, but instead lawmakers can talk about how they are working to ensure access.

Second, Obamacare used unprecedented tactics to shield IPAB from public accountability, including the absurd tactic of making it illegal for the House of Representatives to repeal IPAB. Created bys ections 3403 and 10320 of the Patient Protection and Affordable Care Act, the law actually says a bill to repeal IPAB “shall not be in order” on the House or Senate floor.

That alone warrants an especially public rebuke of IPAB as Republicans work to repeal the entire law. The important point is to ensure that future Congresses see the structure of IPAB as a failed gambit that will not work if they are similarly tempted to fence off the laws they are passing from future lawmakers.

Sadly the atrocious “not in order” provisions are just one tactic Democrats used to handcuff the American people and keep us from changing the IPAB. The Patent Protection and Affordable Care Act (yes, Obamacare) also says the president is not permitted to fire any of the officials appointed to IPAB. Obamacare gave the IPAB the power to rewrite the law! Democrats believed it was a good idea to give the IPAB powers similar to the Supreme Court by saying its recommendations go into effect unless specifically rejected under ridiculous rules designed never to be met.

Frankly, IPAB is a panel of health care rationers given unconstitutional authority to rewrite our laws in the name of price controls. What could possibly go wrong?

The question we Americans should be asking is, why is IPAB still in existence?

One argument is that isolating the least popular provisions of the law into stand-alone bills will make the final repeal and replace bill (the eventual big, controversial bill) less palatable.

But remember the last debate and try to imagine the next one: Did we spend a lot of time discussing IPAB? Unless it’s something that makes Republicans look bad, it’s not going to be a main item of discussion for the media. IPAB definitely does not make Republicans look bad, ergo, it will be left almost untouched, just like it was when Republicans tried to pass their first attempt at repeal and replace.

However, a stand-alone IPAB repeal bill will force Democrats and the media to discuss IPAB. Will Chuck Schumer defend death panels? Will Joe Manchin? It’s easy to imagine the IPAB repeal bill splitting Democrats, helping to demoralize their activist groups ahead of future repeal and replace battles.

Look, it’s no secret the GOP has had trouble coming together on health care. But most of the conflict is not about repealing Obamacare, it’s about with what to replace it. Politically, an IPAB repeal will put points on the board while those issues are sorted out. It’s a big win that helps Republicans move the ball forward, and they should move quickly to get this monstrosity off the books.

About the Author

Daniel Horowitz is an independent consultant specializing in public policy strategy, coalition building and development. He has served as staff for conservative Members in both the U.S. House and Senate.